Item:[lblItem]|||
[lblAddtlItemDescr]|||
Damage Description:[lblDamage]|||
[lblAddtlDamageDescr]|||
Packed By:[lblPackedBy] Inventory #:[lblInvNbr]|||
Date Purchased:[lblDatePurchased] Original Cost:[lblOriginalCost] Replacement Cost:[lblReplacementCost]|||
Amount Claimed or Repair:[lblAmtClmdRepair]|||